BackgroundPlacental soluble fms-like tyrosine kinase-1 (sFlt-1) which is an antagonist of vascular endothelial growth factor and placental growth factor (PIGF), is considered as one of etiology factors cause endothelial damage in preeclampsia due to increase of sFlt-1 level that change vascular endothelial integrity. This study aims to analyze the difference of sFlt-1 and PlGF concentration in severe preeclampsia and normal pregnancy, and the correlation between both in occurrence of severe preeclampsia.MethodThis is case control study involving 18 subjects with severe preeclampsia and 19 subjects with normal pregnancy as controls who met inclusion and exclusion criteria. Concentration of sFlt-1 and PlGF are measured with ELISA. Statistical analysis is performed with Chi square test, Fisher’s exact test, T test, Mann–Whitney test, and Spearman’s rank correlation test.ResultsThis study results in no significant difference in characteristics of gestational age, and parity in both study groups. Median concentration of sFlt-1 in severe preeclampsia is higher (20,524.75 pg/mL) compared with normal pregnancy (6820.4 pg/mL). Concentration of PlGF is lower in severe preeclampsia (47 pg/mL) compared with normal pregnancy (337 pg/mL). sFlt-1 concentration is higher in severe preeclampsia compared to normal pregnancy. PlGF concentration is lower in severe preeclampsia compared to normal pregnancy. Ratio of sFlt-1 and PlGF concentration is significantly correlated in both severe preeclampsia and normal pregnancy.ConclusionsThere is a significant negative correlation between the concentration of sFLt-1 and PlGF in normal pregnancy.

BackgroundPreeclampsia is a major cause of morbidity and mortality, both maternal and perinatal. The etiology and pathophysiology of preeclampsia remain unknown. Research shows the implantation of the placenta in preeclampsia occurs due to incomplete angiogenic imbalance as one of the preeclampsia pathogenesis. PlGF is angiogenic protein which is synthesized in placenta by mRNA PlGF. When damage occurs, mRNA will be released from cell and form cell-free mRNA. This study aims to analyze the differences between the PlGF mRNA expression in severe preeclampsia and normal pregnancy as well as to measure the relationship between cell-free mRNA and levels of PlGF with the incidence of severe preeclampsia.MethodsThe method used in this study is an observational analytic study with cross-sectional design. Blood samples were obtained from patients with preeclampsia and normal pregnancies as the controlling factors in accordance with inclusion and exclusion criterias. Examination of the PlGF level was measured by ELISA method and mRNA PIGF expression was measured by RT-PCR. Physical and laboratory examinations of patients were recorded and collected as data. Calculations were done by statistical analysis.ResultsMean of the cell-free mRNA PlGF expression level in severe preeclampsia is 2.2983 ng/mL within the scale of 1.96–2.83 ng/mL and deviation standard of 0.1897. Using Pearson Analysis Test, the result shows that there is a positive correlation between cell-free mRNA expression and PlGF protein level in severe preeclampsia, with r = 0.640 dan p < 0.004.ConclusionThere is no difference between expression of cell-free mRNA PlGF in severe preeclampsia serum and normal pregnancy. There is a significant correlation between expression of cell-free mRNA and PlGF protein level in severe preeclampsia.

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: Preeclampsia is multisystem disease occurred in 3-8% pregnancy, indicated by hypertension and proteinuria after 20 weeks of gestational age. In preeclamptic patients, pro-oxidant decrease enzymatically in cell, followed by increase in lipid peroxida due to free radicals malondialdehyde (MDA). Elevated free radicals in preeclampsia is associated with reduced cellular antioxidants. Curcumin has been known to posses many biological activities, such as antiinflamation and antioxidants. We evaluated effects of curcumin on MDA level in preeclampia-induced HUVEC cell line. In the present study, we observed the effects of curcumin on MDA level in preeclampia-induced HUVEC cell line. MDA level was measured with Thiobarbituric Acid-reactive Substances (TBARS). The result of the present study showed curcumin decreased MDA level in preeclampsia-induced cell.

BACKGROUND: Cholecalciferol, hepcidin, and soluble transferrin receptor (sTfR) interaction play an essential role in iron hemostasis. Anemia in pregnancy contributes to morbidity and mortality both for the mother and baby. In this study, we assessed the correlation between hepcidin, sTfR and cholecalciferol in third trimester maternal anemia. We aimed to find the cut-off for hepcidin and sTfR.METHODS: A case-control study involving 56 pregnant women in each anemia and healthy group was nested on a previous larger cohort study in Indonesia. Serum hepcidin, sTfR and cholecalciferol level were measured by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: Serum hepcidin and sTfR level were significantly higher in case group, while serum cholecalciferol level has no difference between the two groups. New cut-off points were found for hepcidin (<15.93 ng/mL) and sTfR level (>2234.45 ng/mL). Low level of hepcidin (OR=5.32) and high level of sTfR (OR=8.28) increase the risk of anemia. High level of sTfR (adjusted OR=4.725; CI 95%=1.730-12.904; p=0.02) was the most important factor contributes to anemia, followed by the low level of hepcidin (adjusted OR=3.677; CI 95%=1.363-9917; p=0.01).CONCLUSION: The high level of sTfR is the most important factor related to anemia in the third trimester, followed by the low level of hepcidin. Low cholecalciferol level tends to favor the incident of anemia. The new cut-off point of third trimester sTfR and third trimester hepcidin were established in this study and may be useful for risk assessment and treatment monitoring for anemia in pregnancy.KEYWORDS: anemia, cholecalciferol, hepcidin, pregnancy, soluble transferrin receptor

Objectives:To evaluate the value of uterine artery Doppler in predicting adverse pregnancy outcomes among women with chronic hypertension in a tertiary hospital. Methods: This is a retrospective diagnostic validity study evaluating the value of uterine artery (UA) Doppler at 18-24 weeks age of gestation in predicting adverse pregnancy outcomes among women with Chronic Hypertension (CH) in a tertiary hospital from January 1, 2012 to December 31, 2013, who delivered 24 weeks or more. CH was defined as persistent BP greater than 140/90 mmHg diagnosed before pregnancy or before 20 gestation. Abnormal UA Doppler was described as the presence of an elevated uterine artery resistance index or the presence of a diastolic notch or both. Patients diagnosed with fetal congenital anomaly, other medical problems and higher order gestation were excluded. Results: Fifty-five % CH women had an abnormal UA Doppler and 45%of them had normal results. Among the CH patients with abnormal UA Doppler, the most common adverse pregnancy outcomes were superimposed pre-eclampsia (SPE) (57%), preterm delivery (43%), and IUGR (27%). The findings of abnormal UA Doppler has a high sensitivity of 92.6% and specificity of 63.3% for the development of SPE, with a PPV of 57% and a high negative predictive value of 94%. The positive likelihood ratio (LR) of CH women with abnormal UA Doppler to develop SPE is 2.5 higher compared to those with normal UA Doppler. Abnormal UA Doppler has a sensitivity of 38.1% and a specificity of 83.3% to have babies that are SGA with a positive LR of 2.29, PPV of 72.7% and negative predictive value of 53.6%. Abnormal UA Doppler has a low sensitivity of 5% and but a high specificity of 100% for stillbirth with a PPV 100% and negative predictive value of 46%. Conclusions: UA Doppler study between 18-24 weeks gestation among CH women could be a good predictor and screening tool to asses high risk women to develop adverse pregnancy outcomes especially superimposed pre-eclampsia. EP16.05 Effect of curcumin in decreasing MDA level in pre-eclampsia-induced human umbilical vein endothelial cell (HUVEC)C. Yeni, J. Mose, R. Ruslami, A. Maskoen, P. Fauziah Obstetrics and Gynecology, Faculty of Medicine, Banda Aceh, Aceh, IndonesiaObjectives: Pre-eclampsia is multisystem disease occurred in 3-8% pregnancy, indicated by hypertension and proteinuria after 20 weeks of gestational age. In pre-eclamptic patients, pro-oxidant decrease enzymatically in cell, followed by increase in lipid peroxida due to free radicals malondialdehyde (MDA). Elevated free radicals in pre-eclampsia is associated with reduced cellular antioxidants. Curcumin has been known to posses many biology activities, such as anti-inflammation and antioxidants. Methods: We evaluated effects of curcumin on MDA level in pre-eclampsia induced HUVEC cell line. In the present study, we observe effects of curcumin on MDA level in pre-eclampsia induced HUVEC cell line. MDA level was measured with Thiobarbituric Acid-reactive Substances (TBARS). Results:The result of the pre...

Introduction Preeclampsia is a syndrome that occurs in pregnancy, characterized by hypertension, proteinuria and edema. Zinc and copper are micronutrients that play a role in the performance of several important enzymes in the human body, such as CuZnSOD and ACE2 enzymes that play a role in the pathogenesis of severe preeclampsia. Zinc also plays a role in the kallikrein-kinin system in the formation of bradykinin which then acts as a vasodilator. This study plans to compare the level of copper (Cu), Zink (Zn), and Cu/Zn ratio in preeclamtic and normal pregnancy women. Method The study recruited 30 pregnant women with severe preeclampsia who were treated at Dr. Hasan Sadikin Bandung and 30 normal pregnant women at one of the Independent Practice Midwives in the Cibabat area, which was conducted in the period September 2021 - November 2021. This research was an analytical observational study with a cross sectional study design. Cu and Zn levels were examined using  inductively coupleds plasma mass spectrometry (ICP-MS). Chi Square, student’s t test, Mann Whitney and multivariat analysis were used for statistical analysis. Results The results of this study showed that the average Cu levels were higher in severe preeclampsia (mean: 2.149 vs. 2.116 mol/L, p=0.728). The median Zn level in the subjects with severe preeclampsia was higher than in normal pregnancies (58 vs 49 g/dL, p<0.001). The median Cu/Zn ratio in severe preeclampsia subjects was lower than in normal pregnancies (0.034 vs 0.063 g/dL, p=0.021). Conclusion  Zn levels was significantly increased in the preeclampsia group, Cu  levels was not  significantly increased in the preeclampsia group  and the ratio of Cu/Zn levels was significantly  decreased in  preeclampsia group compared to normal pregnancies.

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